What is enterovirus D68?

First identified in California in 1962, enterovirus D68 (EV-D68) is one of more than 100 non-polio enteroviruses.

How common is EV-D68 in the United States?

Small numbers of EV-D68 have been reported regularly to CDC since 1987. However, during 2014 the number of people reported with confirmed EV-D68 infection was much greater than that reported in previous years. We can’t predict whether EV-D68 will be a common type of enterovirus detected this year or in future seasons. That’s because a mix of enteroviruses circulates every year, and different types of enteroviruses can be common in different years.

What time of the year are people most likely to get infected?

In the United States, you are more likely to get infected with enteroviruses in the summer and fall. However, you can get infected year round.

What are the symptoms of EV-D68 infection?

EV-D68 can cause mild to severe respiratory illness, or no symptoms at all.

Anyone with respiratory illness should contact their doctor if they are having difficulty breathing or if their symptoms are getting worse.

How does the virus spread?

Since EV-D68 causes respiratory illness, the virus can be found in an infected person’s respiratory secretions, such as saliva, nasal mucus, or sputum (mucus-like secretions from the lungs). EV-D68 likely spreads from person to person when an infected person coughs, sneezes, or touches a surface that is then touched by others.

Who is at risk?

In general, infants, children, and teenagers are most likely to get infected with enteroviruses and become ill. That’s because they do not yet have immunity (protection) from previous exposures to these viruses. We believe this is also true for EV-D68. Adults can get infected with enteroviruses, but they are more likely to have no symptoms or mild symptoms.

Children with asthma may have a higher risk for severe respiratory illness caused by EV-D68 infection.

How is it diagnosed?

EV-D68 can only be diagnosed by doing specific lab tests on specimens from a person’s nose and throat, or blood. Many hospitals and some doctor’s offices can test ill patients to see if they have enterovirus infection. However, most cannot do specific testing to determine the type of enterovirus, like EV-D68. CDC and some state health departments can do this sort of testing using a real-time reverse transcription polymerase chain reaction (rRT-PCR) lab test, which allows testing and reporting of results within a few days of receiving specimens. Health departments may contact CDC for further enterovirus typing.

What should people with asthma and children suffering from reactive airway disease do?

Children with asthma may have a higher risk for severe symptoms from EV-D68 and other respiratory illnesses. They should follow CDC’s guidance to maintain control of their illness during enterovirus season, which occurs each year in the U.S. during summer and fall.

A large outbreak of EV-D68 occurred in 2014. How many people got sick?

In summer and fall 2014, the United States experienced a nationwide outbreak of EV-D68 associated with severe respiratory illness. From mid-August 2014 to January 15, 2015, CDC or state public health laboratories confirmed 1,395 people in 49 states and the District of Columbia with respiratory illness caused by EV-D68. Almost all of the confirmed cases were among children, many whom had asthma or a history of wheezing. Additionally, there were likely many thousands of mild EV-D68 infections for which people did not seek medical treatment and/or get tested. This was the first documented nationwide outbreak of EV-D68. Although illness associated with EV-D68 is not notifiable, circulation of this virus occurs most often in late summer and fall, which is the typical enterovirus season.

CDC received about 2,600 specimens for enterovirus testing during 2014, which was substantially more than usual. About 39% of those tested positive for EV-D68. About 40% tested positive for an enterovirus or rhinovirus other than EV-D68.

Will we see another EV-D68 outbreak this year or in future years?

Enteroviruses are ever-present in the community. We can’t predict whether EV-D68 will be a common type of enterovirus detected this year or in other future seasons. A mix of enteroviruses circulates every year, and different types of enteroviruses can be common in different years. Each year we expect to detect cases, but the number of cases identified in the U.S. varies from year to year. As in previous years, CDC will continue to work with states to test specimens for enteroviruses to determine virus type, support the identification and investigation of outbreaks, and monitor seasonal activity.